NRSG 2700 Exam 4 (Units 6&7) UPDATED ACTUAL
Questions and CORRECT Answers
superinfection - occurs when antibiotics kill host flora
- pseudomembranous colitis (C. diff), secondary pneumonia, vaginal/bladder
infection, candida (yeast) infection
- broad-spectrum antibiotics cause more superinfections than narrow-
spectrum
pseudomembranous colitis (C. diff) watery diarrhea, blood, pus, mucous in stool, nausea
secondary pneumonia cough
vaginal/bladder infections bladder pain, problems urinating, abnormal vaginal discharge
candida (yeast) infection abnormal vaginal itching/discharge, soreness/white patches in the mouth
healthcare-associated infections and bacteria - antibiotic use (esp. overuse) results in development of resistant organisms
resistance - these organisms present a major healthcare challenge
- staphylococcus aureus (MRSA), enterococcus faecium (VRE), clostridium
difficile (C.diff), pseudomonas aeruginosa, klebsiella pneumonia
anti-infective drugs - classified by susceptible organisms
- chemical structure (refer to fundamental chemical structure: aminoglycoside,
fluroquinolone, sulfonamide, etc.)
anti-infective drugs mechanisms of action - used to group pharmacologic class
- bacteriostatic, bactericidal, broad spectrum, narrow spectrum
bacterial differentiation - staining of the cell wall (gram positive - thick walls, gram negative - thin walls)
- use of oxygen (aerobic, anaerobic)
- basic shape (bacilli-rod, cocci-sphere, spirilla-spiral)
bacteriostatic drugs that inhibit the growth of bacteria
bactericidal drugs that kill bacteria
broad specrum drugs effective against a wide variety of microbial species
narrow spectrum drugs that are effective only against one or a small number of organisms
expected therapeutic response to antibiotics - decrease symptoms of infection
- decrease bacterial count so the body's immune system can eliminate it
- prevention of infection in some circumstances (immunosuppressed clients,
deep puncture wounds, clients with prosthetic heart valves or joint
replacements, given within 30 minutes pre-op for some surgeries)
, contraindications/cautions with antibiotic therapy - hypersensitivity/allergy is a contraindication (ask the client to describe
symptoms of past allergy)
- viral infections
- some are contraindicated in pregnancy and lactation
- use caution in kidney or liver disease or impairment
potential side effects/adverse reactions to antibiotics - GI: diarrhea, nausea, vomiting
- superinfections
- allergic reactions: itching, hives, angioedema, laryngospasm
Potential Interactions with Antibiotics - Some decrease efficacy of birth control pills
- Bacteriostatic meds may slow the efficacy of bactericidal meds
- Antiacids & PPIs may interfere with po absorption.
antibiotics nursing considerations - whenever possible, obtain culture & sensitivity (C&S) to identify
microorganism and sensitivity to antibiotic before initiating therapy
- administer at evenly spaced intervals to maintain therapeutic blood levels and
prevent pathogenic overgrowth
- monitor for allergic reactions/adverse reactions (especially iV - observe pt
during and after dose)
- monitor for superinfections
antibiotic pt/family teaching - taking all of the prescribed drug even when feeling better
- increase fluid intake
- report signs of a superinfection
cell wall inhibition - penicillins
- cephalosporins
protein synthesis - tetracyclines
- macrolides
DNA replicaiton fluoroquinolones
miscellaneous - sulfonamides
- urinary antiseptics
anti-tuberculosis anti-mycobacterial
penicillin G potassium - cell wall inhibitor
- narrow spectrum
- bactericidal
penicillin G potassium potential side effects/adverse - generally well tolerated
reactions - hypersensitivity/anaphylaxis
- most common reaction is an allergic reaction ranging from urticaria and skin
rash to anaphylaxis; skin rash may be delayed for days or weeks
penicillin G potassium nursing considerations - Watch formulation for inactive ingredients and route
- Use caution if the client has an allergy to cephalosporins
ampicillin - cell wall inhibitor
- broad spectrum
- bactericidal
Questions and CORRECT Answers
superinfection - occurs when antibiotics kill host flora
- pseudomembranous colitis (C. diff), secondary pneumonia, vaginal/bladder
infection, candida (yeast) infection
- broad-spectrum antibiotics cause more superinfections than narrow-
spectrum
pseudomembranous colitis (C. diff) watery diarrhea, blood, pus, mucous in stool, nausea
secondary pneumonia cough
vaginal/bladder infections bladder pain, problems urinating, abnormal vaginal discharge
candida (yeast) infection abnormal vaginal itching/discharge, soreness/white patches in the mouth
healthcare-associated infections and bacteria - antibiotic use (esp. overuse) results in development of resistant organisms
resistance - these organisms present a major healthcare challenge
- staphylococcus aureus (MRSA), enterococcus faecium (VRE), clostridium
difficile (C.diff), pseudomonas aeruginosa, klebsiella pneumonia
anti-infective drugs - classified by susceptible organisms
- chemical structure (refer to fundamental chemical structure: aminoglycoside,
fluroquinolone, sulfonamide, etc.)
anti-infective drugs mechanisms of action - used to group pharmacologic class
- bacteriostatic, bactericidal, broad spectrum, narrow spectrum
bacterial differentiation - staining of the cell wall (gram positive - thick walls, gram negative - thin walls)
- use of oxygen (aerobic, anaerobic)
- basic shape (bacilli-rod, cocci-sphere, spirilla-spiral)
bacteriostatic drugs that inhibit the growth of bacteria
bactericidal drugs that kill bacteria
broad specrum drugs effective against a wide variety of microbial species
narrow spectrum drugs that are effective only against one or a small number of organisms
expected therapeutic response to antibiotics - decrease symptoms of infection
- decrease bacterial count so the body's immune system can eliminate it
- prevention of infection in some circumstances (immunosuppressed clients,
deep puncture wounds, clients with prosthetic heart valves or joint
replacements, given within 30 minutes pre-op for some surgeries)
, contraindications/cautions with antibiotic therapy - hypersensitivity/allergy is a contraindication (ask the client to describe
symptoms of past allergy)
- viral infections
- some are contraindicated in pregnancy and lactation
- use caution in kidney or liver disease or impairment
potential side effects/adverse reactions to antibiotics - GI: diarrhea, nausea, vomiting
- superinfections
- allergic reactions: itching, hives, angioedema, laryngospasm
Potential Interactions with Antibiotics - Some decrease efficacy of birth control pills
- Bacteriostatic meds may slow the efficacy of bactericidal meds
- Antiacids & PPIs may interfere with po absorption.
antibiotics nursing considerations - whenever possible, obtain culture & sensitivity (C&S) to identify
microorganism and sensitivity to antibiotic before initiating therapy
- administer at evenly spaced intervals to maintain therapeutic blood levels and
prevent pathogenic overgrowth
- monitor for allergic reactions/adverse reactions (especially iV - observe pt
during and after dose)
- monitor for superinfections
antibiotic pt/family teaching - taking all of the prescribed drug even when feeling better
- increase fluid intake
- report signs of a superinfection
cell wall inhibition - penicillins
- cephalosporins
protein synthesis - tetracyclines
- macrolides
DNA replicaiton fluoroquinolones
miscellaneous - sulfonamides
- urinary antiseptics
anti-tuberculosis anti-mycobacterial
penicillin G potassium - cell wall inhibitor
- narrow spectrum
- bactericidal
penicillin G potassium potential side effects/adverse - generally well tolerated
reactions - hypersensitivity/anaphylaxis
- most common reaction is an allergic reaction ranging from urticaria and skin
rash to anaphylaxis; skin rash may be delayed for days or weeks
penicillin G potassium nursing considerations - Watch formulation for inactive ingredients and route
- Use caution if the client has an allergy to cephalosporins
ampicillin - cell wall inhibitor
- broad spectrum
- bactericidal
